From the Research
There is no direct causal relationship between high ACE (angiotensin-converting enzyme) levels and high cystatin C levels. While both can be elevated in certain conditions, one does not directly cause the other. Cystatin C is primarily a marker of kidney function, with levels rising when kidney filtration decreases. ACE, on the other hand, is an enzyme involved in blood pressure regulation through the renin-angiotensin-aldosterone system. However, conditions that affect kidney function, such as chronic kidney disease, hypertension, or heart failure, can potentially lead to alterations in both markers. For instance, reduced kidney function can cause elevated cystatin C, while conditions requiring activation of the renin-angiotensin-aldosterone system might show increased ACE activity.
Some key factors that can influence cystatin C levels include age, gender, smoking, diabetes, thyroid and cardiac dysfunctions, as shown in a study published in 2019 1. This study found that diabetes, thyroid and cardiac dysfunctions have a clear impact on the levels of cystatin C in human blood, whereas age, gender and smoking habit have no effect.
It's also worth noting that cystatin C has been associated with an increased risk of heart failure and cardiovascular mortality, as demonstrated in a study published in 2008 2. Additionally, a study published in 2015 found that high serum cystatin C levels are strongly associated with structural cardiac abnormalities such as left ventricular hypertrophy and left atrial enlargement, impaired left ventricular relaxation, and an increased NT-proBNP, independently of eGFR in patients with stage 2 or 3 CKD 3.
If you're experiencing elevated levels of either marker, it's essential to consult with a healthcare provider for proper evaluation, as these changes often reflect underlying health conditions rather than a direct relationship between the two markers themselves. A study published in 2012 highlighted the importance of cystatin C as a marker of renal function and its usefulness for risk stratification in heart failure 4. Furthermore, a study published in 2004 found that serum cystatin C levels are influenced by factors other than renal function alone, and that multivariate serum cystatin C-based estimates of renal function are not superior to multivariate serum creatinine-based estimates 5.
In summary, while high ACE levels and high cystatin C levels can be associated with similar conditions, they are not directly causally related, and their elevation often reflects underlying health conditions that require proper evaluation and management. Therefore, it is crucial to consider the clinical context and underlying health conditions when interpreting elevated levels of either marker.